Acne, Nutrition and Milk Products
Current research is increasingly focused on the connection between nutrition and acne, but the link between milk products and this skin condition remains inconclusive. What researchers are finding is that diets with a low glycemic load and high intake of antioxidants and omega-3 fats may be beneficial in treating acne.
The link between diet and acne has had a rocky past. The topic is still actively being researched, and recent studies have re-examined the possible link between diet and acne. Some interesting new information has come to light. Here’s a look at past studies and where we’re at today.
Studies from the 1940s suggested that some foods were linked to acne.1 However, this early evidence was very weak because the studies were anecdotal and descriptive and had no statistical analyses.
Over the years, high-carbohydrate and high-fat foods along with sweets, chocolates and milk products have been suggested to exacerbate acne.2 This perspective changed in the 1970s when two key studies indicated that there was no association between diet and this skin condition.3,4 However, these studies were criticized because of major methodological limitations. Owing to inconclusive evidence of any true effects of diet, the dermatology community reached the consensus that diet is unrelated to the etiology or progression of acne.
Studies on the connection of milk products to acne have been weak so far. For example, in 2005, Adebamowo et al. used data from the Nurses Health Study to conduct an analysis,5 which showed a positive association between acne and the consumption of milk, particularly skim milk. However, since this study involved adults' trying to remember what they ate as teenagers (i.e., a retrospective design), there is a high likelihood of imprecise food recalls.
A prospective cohort study also conducted by Adebamowo et al. in 2008 examined the association between milk product consumption and acne among teenage boys.6 This study showed no significant associations between acne and total, whole and low-fat milk consumption, with a positive association only between skim milk and acne.
Both of these studies had major limitations, including:7
- Invalidated self-reports instead of objective measures;
- Observational study designs rather than randomized controlled trials;
- Weak associations according to epidemiologic standards, making the clinical significance of the results questionable.
There remains a lack of strong evidence showing a cause-and-effect link between acne and milk products. Moreover, other studies have shown that the milk protein lactoferrin may actually improve acne. A 12-week, double-blind, placebo-controlled trial using lactoferrin-enriched fermented milk showed significant decreases in inflammatory lesion count (38.6%), in total lesion count (23.1%) and in acne grade (20.3%) compared with the placebo group. Plus, sebum content in the lactoferrin group decreased by 31.1% compared with the placebo group.8
Some studies have examined the relationship between acne and glycemic load, which is a method for classifying foods based on both the amount of carbohydrate in the food and how it impacts blood sugar levels. A low glycemic load diet seems to have a favourable role against the pathogenesis of acne.9,10 Foods with a low glycemic load include most fresh fruits and vegetables, bran cereals, and legumes such as chickpeas, kidney beans and lentils.
Other studies have indicated that the consumption of omega-3 fatty acids and antioxidants offers possible benefits for treating acne.7
The relationship between diet and acne remains controversial. Since this is an ongoing area of research, the best advice for now is to continue to recommend a balanced diet based on Canada’s Food Guide.
- Chan JJ and Rohr JB. Acne vulgaris: yesterday, today and tomorrow. Australas J Dermatol 2000;41(Suppl):S69-72.
- Spencer EH et al. Diet and acne: a review of the evidence. Int J Dermatol 2009;48(4):339-47.
- Fulton JE Jr et al. Effect of chocolate on acne vulgaris. JAMA 1969;210(11):2071-4.
- Anderson PC. Foods as the cause of acne. Am Fam Physician 1971;3(3):102-3.
- Adebamowo CA et al. High school dietary dairy intake and teenage acne. J Am Acad Dermatol 2005;52(2):207-14.
- Adebamowo CA et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol 2008;58(5):787-93.
- Bowe WP et al. Diet and acne. J Am Acad Dermatol 2010;63(1):124-41.
- Kim J et al. Dietary effect of lactoferrin-enriched fermented milk on skin surface lipid and clinical improvement of acne vulgaris. Nutrition 2010;26:902-909.
- Smith RN et al. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr 2007;86(1):107-15.
- Smith RN et al. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci 2008;50(1):41-52.